ABSTRACT
INTRODUCTION: Severe sepsis is still associated with significant morbidity and mortality, which is however different, as well as its management, depending on the region. What is the situation in the Czech Republic and what is the character of patients with severe sepsis is currently not known. The aim of the project is to describe the processes of care, outcome and characteristics of patients with severe sepsis admitted to the intensive care department of the Czech Republic. METHODS: This is a multicentre and observational project with retrospective enrollment of patients who meet the criteria for severe sepsis before or within 24 hours after admission to selected intensive care units (ICUâEPOSS). RESULTS: 394 patients were analyzed. Median age at admission was 66 (56-â76) years, males predominated (58.9%) and the median APACHE II score on admission was 25 (19-â32). Patients were predominantly medical (56.9%) and most were secondary admitted from other ICU (53.6%). Meeting the criteria of severe sepsis was most frequently within the period (± 4 hours) of admission the EPOSSâICU (77.6%). Median total fluid intake during the first 24 hours was 6,680 (4,840-â9,450) ml. Most patients required mechanical ventilation (58.4%). Compliance with the resuscitation bundle of severe sepsis in our group was very good and was associated with lower mortality of patients. Most frequently, the EPOSSâICU length of stay (LOS) was 7 (3-â15) days and median hospital LOS was 13 (8-â28) days. Hospital mortality in our cohort was 35.8%. CONCLUSION: Introducing the project, which in its first stage obtained valuable and internationally comparable data about patients with severe sepsis admitted to the involved ICU in the Czech Republic.
Subject(s)
Cross Infection/therapy , Intensive Care Units , Sepsis/therapy , Adult , Aged , Cross Infection/diagnosis , Cross Infection/mortality , Czech Republic , Female , Guideline Adherence , Hospital Mortality , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Pilot Projects , Respiration, Artificial , Resuscitation , Retrospective Studies , Sepsis/diagnosis , Sepsis/mortalityABSTRACT
Electrical burns are not ranked among the most frequent type of injuries, but they have the most devastating potential of all thermal injuries and often cause lifelong stigmatization. Those primarily affected are young males: work injuries predominate. An electrical burn is a specific nosological unit that has multiple acute and chronic abnormal manifestations. In this study we describe the case of a young man who suffered an electrical injury after contact with a high-voltage line (22,000 volts) while paragliding. This contact was followed by a 10 m fall. In our work we present the need for multidisciplinary cooperation along with the opportunities, problems and risks that accompany the treatment of this type of injury.